Logotherapy

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Logotherapy was developed by neurologist and psychiatrist Viktor Frankl [1] and is based on the premise that the primary motivational force of an individual is to find a meaning in life. [2] Frankl describes it as "the Third Viennese School of Psychotherapy" [3] [4] along with Freud's psychoanalysis and Alfred Adler's individual psychology. [5]

Contents

Logotherapy is based on an existential analysis [6] focusing on Kierkegaard's will to meaning as opposed to Adler's Nietzschean doctrine of will to power or Freud's will to pleasure . Rather than power or pleasure, logotherapy is founded upon the belief that striving to find meaning in life is the primary, most powerful motivating and driving force in humans. [2] A short introduction to this system is given in Frankl's most famous book, Man's Search for Meaning (1946), in which he outlines how his theories helped him to survive his Holocaust experience and how that experience further developed and reinforced his theories. Presently, there are a number of logotherapy institutes around the world.

Basic principles

The notion of logotherapy was created with the Greek word logos ("meaning"). Frankl's concept is based on the premise that the primary motivational force of an individual is to find meaning in life. The following list of tenets represents basic principles of logotherapy:

The human spirit is referred to in several of the assumptions of logotherapy, but the use of the term spirit is not "spiritual" or "religious." In Frankl's view, the spirit is the will of the human being. The emphasis, therefore, is on the search for meaning, which is not necessarily the search for God or any other supernatural being. [2] Frankl also noted the barriers to humanity's quest for meaning in life. He warns against "...affluence, hedonism, [and] materialism..." in the search for meaning. [7]

Purpose in life and meaning in life constructs appeared in Frankl's logotherapy writings with relation to existential vacuum and will to meaning, as well as others who have theorized about and defined positive psychological functioning. Frankl observed that it may be psychologically damaging when a person's search for meaning is blocked. Positive life purpose and meaning were associated with strong religious beliefs, membership in groups, dedication to a cause, life values, and clear goals. Adult development and maturity theories include the purpose in life concept. Maturity emphasizes a clear comprehension of life's purpose, directedness, and intentionality which contributes to the feeling that life is meaningful. [8]

Frankl's ideas were operationalized by Crumbaugh and Maholick's Purpose in Life (PIL) test, which measures an individual's meaning and purpose in life. [8] With the test, investigators found that meaning in life mediated the relationships between religiosity and well-being; [9] uncontrollable stress and substance use; depression and self-derogation. [8] [10] Crumbaugh found that the Seeking of Noetic Goals Test (SONG) is a complementary measure of the PIL. While the PIL measures the presence of meaning, the SONG measures orientation towards meaning. A low score in the PIL but a high score in the SONG, would predict a better outcome in the application of Logotherapy. [11]

Discovering meaning

According to Frankl, "We can discover this meaning in life in three different ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering" and that "everything can be taken from a man but one thing: the last of the human freedoms – to choose one's attitude in any given set of circumstances". [3] On the meaning of suffering, Frankl gives the following example:

"Once, an elderly general practitioner consulted me because of his severe depression. He could not overcome the loss of his wife who had died two years before and whom he had loved above all else. Now how could I help him? What should I tell him? I refrained from telling him anything, but instead confronted him with a question, "What would have happened, Doctor, if you had died first, and your wife would have had to survive without you?:" "Oh," he said, "for her this would have been terrible; how she would have suffered!" Whereupon I replied, "You see, Doctor, such a suffering has been spared her, and it is you who have spared her this suffering; but now, you have to pay for it by surviving and mourning her." He said no word but shook my hand and calmly left the office. [3] : 178–179 

Frankl emphasized that realizing the value of suffering is meaningful only when the first two creative possibilities are not available (for example, in a concentration camp) and only when such suffering is inevitable –he was not proposing that people suffer unnecessarily. [12] : 115 

Philosophical basis of logotherapy

Frankl described the meta-clinical implications of logotherapy in his book The Will to Meaning: Foundations and Applications of Logotherapy. [13] He believed that there is no psychotherapy apart from the theory of the individual. As an existential psychologist, he inherently disagreed with the "machine model" or "rat model", as it undermines the human quality of humans. As a neurologist and psychiatrist, Frankl developed a unique view of determinism to coexist with the three basic pillars of logotherapy (the freedom of will). Though Frankl admitted that a person can never be free from every condition, such as, biological, sociological, or psychological determinants; based on his experience during his life in the Nazi concentration camps, he believed that a person is "capable of resisting and braving even the worst conditions". In doing such, a person can detach from situations and themselves, choose an attitude about themselves, and determine their own determinants, thus shaping their own character and becoming responsible for themselves. [14]

Logotherapeutic views and treatment

Overcoming anxiety

By recognizing the purpose of our circumstances, one can master anxiety. Anecdotes about this use of logotherapy are given by New York Times writer Tim Sanders, who explained how he uses its concept to relieve the stress of fellow airline travelers by asking them the purpose of their journey. When he does this, no matter how miserable they are, their whole demeanor changes, and they remain happy throughout the flight. [15] Overall, Frankl believed that the anxious individual does not understand that their anxiety is the result of dealing with a sense of "unfulfilled responsibility" and ultimately a lack of meaning. [16]

Treatment of neurosis

Frankl cites two neurotic pathogens: hyper-intention, a forced intention toward some end which makes that end unattainable; and hyper-reflection, an excessive attention to oneself which stifles attempts to avoid the neurosis to which one thinks oneself predisposed. Frankl identified anticipatory anxiety, a fear of a given outcome which makes that outcome more likely. To relieve the anticipatory anxiety and treat the resulting neuroses, logotherapy offers paradoxical intention, wherein the patient intends to do the opposite of their hyper-intended goal.

A person, then, who fears (i.e. experiences anticipatory anxiety over) not getting a good night's sleep may try too hard (that is, hyper-intend) to fall asleep, and this would hinder their ability to do so. A logotherapist would recommend, then, that the person go to bed and intentionally try not to fall asleep. This would relieve the anticipatory anxiety which kept the person awake in the first place, thus allowing them to fall asleep in an acceptable amount of time. [3]

Depression

Viktor Frankl believed depression occurred at the psychological, physiological, and spiritual levels. [16] At the psychological level, he believed that feelings of inadequacy stem from undertaking tasks beyond our abilities. At the physiological level, he recognized a "vital low", which he defined as a "diminishment of physical energy". [16] Finally, Frankl believed that at the spiritual level, the depressed individual faces tension between who they actually are in relation to what they should be. Frankl refers to this as the gaping abyss. [12] : 202  [16] Finally Frankl suggests that if goals seem unreachable, an individual loses a sense of future and thus meaning, resulting in depression. [16] Thus logotherapy aims "to change the patient's attitude toward their disease as well as toward their life as a task". [12] : 200 

In order to overcome depressed feelings and thoughts, Frankl challenges individuals who suffer from depression to find meaning in their suffering. [17] Frankl frequently cites Nietzsche's words, "If we have our own why in life, we shall get along with almost any how". [18] Suffering and all the negative emotions that come with it are a normal part of the human experience and should even be expected. Edith Weisskopf-Joelson, a psychologist and follower of logotherapy, argues that "our current mental-hygiene philosophy stresses the idea that people ought to be happy, that unhappiness is a symptom of maladjustment. Such a value system might be responsible for the fact that the burden of unavoidable unhappiness is increased by unhappiness about being unhappy". [19]

Obsessive–compulsive disorder

Frankl believed that those with obsessive–compulsive disorder lack the sense of completion that most other individuals possess. [16] Instead of fighting the tendencies to repeat thoughts or actions, or focusing on changing the individual symptoms of the disease, the therapist should focus on "transform[ing] the neurotic's attitude toward their neurosis". [12] : 185  Therefore, it is important to recognize that the patient is "not responsible for his obsessional ideas", but that "he is certainly responsible for his attitude toward these ideas". [12] : 188  Frankl suggested that it is important for the patient to recognize their inclinations toward perfection as fate, and therefore, must learn to accept some degrees of uncertainty. [16] Ultimately, following the premise of logotherapy, the patient must eventually ignore their obsessional thoughts and find meaning in their life despite such thoughts. [12]

Schizophrenia

Though logotherapy was not intended to deal with severe disorders, Frankl believed that logotherapy could benefit even those with schizophrenia. [16] He recognized the roots of schizophrenia in physiological dysfunction. [16] In this dysfunction, the person with schizophrenia "experiences himself as an object" rather than as a subject. [12] : 208  Frankl suggested that a person with schizophrenia could be helped by logotherapy by first being taught to ignore voices and to end persistent self-observation. [16] Then, during this same period, the person with schizophrenia must be led toward meaningful activity, as "even for the schizophrenic there remains that residue of freedom toward fate and toward the disease which man always possesses, no matter how ill he may be, in all situations and at every moment of life, to the very last". [12] : 216 

Terminally ill patients

In 1977, Terry Zuehlke and John Watkins conducted a study analyzing the effectiveness of logotherapy in treating terminally ill patients. The study's design used 20 male Veterans Administration volunteers who were randomly assigned to one of two possible treatments – (1) group that received eight 45-minute sessions over a 2-week period and (2) group used as control that received delayed treatment. Each group was tested on five scales – the MMPI K Scale, MMPI L Scale, Death Anxiety Scale, Brief Psychiatric Rating Scale, and the Purpose of Life Test. The results showed an overall significant difference between the control and treatment groups. While the univariate analyses showed that there were significant group differences in 3/5 of the dependent measures. These results confirm the idea that terminally ill patients can benefit from logotherapy in coping with death. [20]

Forms of treatment

Ecce Homo is a method used in logotherapy. It requires of the therapist to note the innate strengths that people have and how they have dealt with adversity and suffering in life; to ask the patient to consider how, despite everything a person may have gone through, they made the best of their suffering. The method is called "Ecce Homo", which is Latin for "Behold the Man", because the method involves beholding how other people have made the best of their adversity. [21]

Critiques

Authoritarianism

In 1961 Rollo May argued that logotherapy is, in essence, authoritarian. He suggested that Frankl's therapy presents a plain solution to all of life's problems, an assertion that would seem to undermine the complexity of human life itself. May contended that if a patient could not find their own meaning, Frankl would provide a goal for his patient. In effect, this would negate the patient's personal responsibility, thus "diminish[ing] the patient as a person". [22] Frankl explicitly replied to May's arguments through a written dialogue, sparked by Rabbi Reuven Bulka's article "Is Logotherapy Authoritarian?". [23] Frankl responded that he combined the prescription of medication, if necessary, with logotherapy, to deal with the person's psychological and emotional reaction to the illness, and highlighted areas of freedom and responsibility, where the person is free to search and to find meaning. [24]

Religiousness

Critical views of the life and word of logotherapy's founder and his work assume that Frankl's religious background [25] and experience of suffering guided his conception of meaning within the boundaries of the person [26] and therefore that logotherapy is founded on Viktor Frankl's worldview. [27] Some researchers argue that logotherapy is not a "scientific" psychotherapeutic school in the traditional sense but a philosophy of life, a system of values, or a secular religion [28] that is not fully coherent and based on questionable metaphysical premises. [29]

Frankl openly spoke and wrote on religion and psychiatry, throughout his life, and specifically in his last book, Man's Search for Ultimate Meaning (1997). He asserted that every person has a spiritual unconscious, independently of religious views or beliefs, yet Frankl's conception of the spiritual unconscious does not necessarily entail religiosity. In Frankl's words: "It is true, Logotherapy, deals with the Logos; it deals with Meaning. Specifically, I see Logotherapy in helping others to see meaning in life. But we cannot "give" meaning to the life of others. And if this is true of meaning per se, how much does it hold for Ultimate Meaning?" [30] The American Psychiatric Association awarded Viktor Frankl the 1985 Oskar Pfister Award (for important contributions to religion and psychiatry). [30]

Recent developments

Since the 1990s, the number of institutes providing education and training in logotherapy continues to increase worldwide.VFI / Institutes worldwide (E) Numerous logotherapeutic concepts have been integrated and applied in different fields, such as cognitive behavioral therapy, [31] acceptance and commitment therapy (ACT), [32] and burnout prevention. [33] The logotherapeutic concepts of noogenic neurosis and existential crisis were added to the ICD 11 under the name demoralisation crisis, i.e. a construct that features hopelessness, meaninglessness, and existential distress as first described by Frankl in the 1950s. [34] [35] Logotherapy has also been associated with psychosomatic and physiological health benefits. [36] [37] [38] [39] [40] [41] Besides Logotherapy, other meaning-centered psychotherapeutic approaches such as positive psychology and meaning therapy have emerged. [42] [43] Paul Wong's meaning therapy attempts to translate logotherapy into psychological mechanisms, integrating cognitive behavioral therapy, positive psychotherapy and the positive psychology research on meaning. [44] [45] Logotherapy is also being applied in the field of oncology [46] [47] and palliative care (William Breitbart). [48] These recent developments introduce Viktor Frankl's logotherapy to a new generation and extend its impact to new areas of research. [49]

Locations

A number of logotherapeutic institutes have opened up in various countries around the world and include:

Africa

  • Viktor Frankl Institute of Logotherapy South Africa [50]

Asia

  • The Viktor Frankl Center for Logotherapy in Israel [51]
  • Japan Logotherapist Association [52]

Australia

  • Viktor Frankl Institute Australia [53]

Europe

  • Viktor Frankl Zentrum Wien [54]
  • Viktor Frankl Institute of Ireland [55]
  • Logotherapy Institute of Finland [56]
  • Logotherapy Institute of Serbia [57]
  • Viktor Frankl Institute of Logotherapy - Prague, Czech Republic [58]
  • Viktor Frankl Institute of Turkey [59]

North America

  • Viktor Frankl Institute of Logotherapy - Stamford, Texas [60]
  • Arizona Institute of Logotherapy [61]
  • Canadian Institute of Logotherapy - Ottawa, Canada [62]
  • Sociedad Mexicana de Análisis Existencial y Logoterapia [63]

South America

  • Fundacion Argentina de Logoterapia - Buenos Aires [64]
  • Associação Brasileira de Logoterapia e Análise Existencial Frankliana (SOBRAL) [65]

Online

  • Viktor Frankl Institute - Vienna, Austria [66]
  • Viktor Frankl Institute of America [67]

See also

Related Research Articles

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.

Paradoxical intention (PI) is a psychotherapeutic technique used to treat recursive anxiety by repeatedly rehearsing the anxiety-inducing pattern of thought or behaviour, often with exaggeration and humor. Paradoxical intention has been shown to be effective in treating psychosomatic illnesses such as chronic insomnia, public speaking phobias, etc. by making patients do the opposite of their hyper-intended goal, hindering their ability to perform the activity.

<span class="mw-page-title-main">Viktor Frankl</span> Austrian Holocaust survivor, neurologist, psychologist, philosopher, and author (1905–1997)

Viktor Emil Frankl was an Austrian neurologist, psychologist, philosopher, and Holocaust survivor, who founded logotherapy, a school of psychotherapy that describes a search for a life's meaning as the central human motivational force. Logotherapy is part of existential and humanistic psychology theories.

<span class="mw-page-title-main">Rollo May</span> American psychologist (1909–1994)

Rollo Reece May was an American existential psychologist and author of the influential book Love and Will (1969). He is often associated with humanistic psychology and existentialist philosophy, and alongside Viktor Frankl, was a major proponent of existential psychotherapy. The philosopher and theologian Paul Tillich was a close friend who had a significant influence on his work.

<i>Mans Search for Meaning</i> 1946 book by Viktor Frankl

Man's Search for Meaning is a 1946 book by Viktor Frankl chronicling his experiences as a prisoner in Nazi concentration camps during World War II, and describing his psychotherapeutic method, which involved identifying a purpose to each person's life through one of three ways: the completion of tasks, caring for another person, or finding meaning by facing suffering with dignity.

Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

Existential psychotherapy is a form of psychotherapy based on the model of human nature and experience developed by the existential tradition of European philosophy. It focuses on concepts that are universally applicable to human existence including death, freedom, responsibility, and the meaning of life. Instead of regarding human experiences such as anxiety, alienation and depression as implying the presence of mental illness, existential psychotherapy sees these experiences as natural stages in a normal process of human development and maturation. In facilitating this process of development and maturation existential psychotherapy involves a philosophical exploration of an individual's experiences while stressing the individual's freedom and responsibility to facilitate a higher degree of meaning and well-being in his or her life.

<span class="mw-page-title-main">Existential crisis</span> Inner conflict due to perceived meaninglessness

Existential crises are inner conflicts characterized by the impression that life lacks meaning and confusion about one's personal identity. They are accompanied by anxiety and stress, often to such a degree that they disturb one's normal functioning in everyday life and lead to depression. Their negative attitude towards meaning reflects characteristics of the philosophical movement of existentialism. The components of existential crises can be divided into emotional, cognitive, and behavioral aspects. Emotional components refer to the feelings, such as emotional pain, despair, helplessness, guilt, anxiety, or loneliness. Cognitive components encompass the problem of meaninglessness, the loss of personal values or spiritual faith, and thinking about death. Behavioral components include addictions, and anti-social and compulsive behavior.

Meaning in existentialism is descriptive; therefore it is unlike typical, prescriptive conceptions of "the meaning of life". Due to the methods of existentialism, prescriptive or declarative statements about meaning are unjustified. The root of the word "meaning" is "mean", which is the way someone or something is conveyed, interpreted, or represented. Each individual has his or her own form of unique perspective; meaning is, therefore, purely subjective. Meaning is the way something is understood by an individual; in turn, this subjective meaning is also how the individual may identify it. Meaning is the personal significance of something physical or abstract. This would include the assigning of value(s) to such significance.

The will to live is a concept developed by the German philosopher Arthur Schopenhauer, representing an irrational "blind incessant impulse without knowledge" that drives instinctive behaviors, causing an endless insatiable striving in human existence.

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The tragic triad is a term used in logotherapy, coined by Dr. Viktor Frankl. The tragic triad refers to three experiences which often lead to existential crisis, namely, guilt, suffering or death. The concept of the tragic triad is used in identifying the life meanings of patients, or the relatives of patients, experiencing guilt, suffering or death. These life meanings are analyzed using logotherapy's existential analysis with the intent of assisting the patient overcome their existential crisis by discovering meaning or purpose in the experience.

<span class="mw-page-title-main">Meaning-making</span> Process of understanding changes in life

In psychology, meaning-making is the process of how people construe, understand, or make sense of life events, relationships, and the self.

<i>Existential Psychotherapy</i> (book) Book by Irvin D. Yalom

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Second-wave positive psychology is a therapeutic approach in psychology that attempts to bring out the best in individuals and society by incorporating the dark side of human existence through the dialectical principles of yin and yang. This represents a distinct shift from focusing on individual happiness and success to the dual vision of individual well-being and collective humanity. PP 2.0 is more about bringing out the "better angels of our nature" than achieving optimal happiness or personal success. The approach posits that empathy, compassion, reason, justice, and self-transcendence will improve humans, both individually and collectively. PP 2.0 centers around the universal human capacity for meaning-seeking and meaning-making in achieving optimal human functioning under both desirable and undesirable conditions. This emerging movement is a response to perceived problems of what some have called "positive psychology as usual".

Elisabeth Lukas is an Austrian psychiatrist and is one of the central figures in logotherapy, a branch of psychotherapy founded by Viktor Frankl. Lukas is an author of 30 books, translated into 16 languages.

References

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  44. ↑ Wong, P. T. P. (2016). Integrative meaning therapy: From logotherapy to existential positive interventions. In P. Russo-Netzer, S. E. Schulenberg, & A. Batthyany (Eds.). To thrive, to cope, to understand: Meaning in positive and existential psychotherapy (pp. 0-0). New York, NY: Springer.
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  54. ↑ "Herzlich willkommen im VIKTOR FRANKL ZENTRUM WIEN!". www.franklzentrum.org.
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  56. ↑ "Logotherapy Institute of Finland".
  57. ↑ "Logotherapy Institute of Serbia".
  58. ↑ "Viktor Frankl Institute of Logotherapy - Prague, Czech Republic".
  59. ↑ "Viktor Frankl Enstitüsü Türkiye".
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  61. ↑ "Arizona Institute of Logotherapy". Archived from the original on 2017-10-24. Retrieved 2018-03-11.
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  65. ↑ "Home". Sobral.
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